Healthcare Provider Details

I. General information

NPI: 1497486732
Provider Name (Legal Business Name): ACARE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12220 ATLANTIC BLVD STE 130
JACKSONVILLE FL
32225-5826
US

IV. Provider business mailing address

9568 STRATHAM CT
JACKSONVILLE FL
32244-7172
US

V. Phone/Fax

Practice location:
  • Phone: 904-753-7566
  • Fax:
Mailing address:
  • Phone: 904-753-7566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMARIS MONIQUE NELSON
Title or Position: OWNER
Credential:
Phone: 904-753-7566